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KU mindfulness program addresses stress, burnout doctors feel amid COVID-19

KU School of Medicine-Wichita researchers study the pandemic's emotional toll on Kansas family physicians, implement program to help address burnout

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Maurice Duggins, M.D., FAAFP, practices breathing exercises in his office to help him reduce tension and enhance focus. He said, “Many times this has to be done during the work hours.”

Recent work by KU School of Medicine-Wichita researchers has documented not only the emotional toll of being a doctor amid COVID-19 but also spurred a program to help address anxiety, stress, depression, detachment and other signs of burnout.

The recent program, which KU School of Medicine-Wichita’s Samuel Ofei-Dodoo described as an intervention, used brief mindfulness-based techniques such as deep breathing and meditation with a group of residents and faculty in the Ascension Via Christi family medicine residency program. Sixteen residents and five faculty took part in weekly sessions in person or virtually, and the 75-minute programs were recorded so they could be watched later by others. Topics included emotional intelligence, awareness, stress and resilience, and community building.

Dr. Ofei-Dodoo“The program was a time-efficient way to improve resilience. In medicine, compassion is one of the key attributes people need to show. There was an improvement in resilience, in compassion, and we also experienced a reduction in anxiety and stress,” said Ofei-Dodoo, Ph.D., MPA, M.A., CPH, an assistant professor and director of residency research in the Department of Family & Community Medicine.

With additional funding, he said, a broader study could be conducted that could clearly establish the correlation between the approach and its success.

The initial program occurred through the support of the Via Christi Philanthropic Foundation, which donated $15,000 used to hire consultants specializing in mindfulness-based stress reduction. Before and after the eight-week program, participants were surveyed on a number of stress and burnout indicators. The research, titled “Brief Mindfulness Intervention for Burnout, Quality of Life, and Compassion in Family Physicians During COVID-19: A Pilot Study,” is under review with the Society of Teachers of Family Medicine's journal, PRiMER.

The mindfulness research builds upon a study published in the May-June issue of the Journal of the American Board of Family Medicine. That study, “Burnout, Depression, Anxiety, and Stress Among Family Physicians in Kansas Responding to the COVID-19 Pandemic,” was done by Ofei-Dodoo; Colleen Loo-Gross, M.D., MPH; and Rick Kellerman, M.D. Loo-Gross is an assistant professor in the Department of Family & Community Medicine, while Kellerman is department chair.

Conducted in May and June 2020 and encompassing responses from 113 Kansas physicians, the burnout study involved questions seeking to examine the levels of depression, anxiety, stress and burnout. The results were startling, with just over half of the doctors reporting manifestations of burnout. Those who had directly treated confirmed or presumed cases of COVID-19 were four times more likely to have at least one indicator of burnout and three times more likely to have experienced emotional exhaustion.

Ofei-Dodoo sees the results of the burnout study as a call to action, and efforts like the mindfulness program as a possible solution.

“Policymakers and health care organizations can help,” he said, “by recognizing the harmful effects of emotional distress on the well-being of these health care professionals and by ensuring appropriate programs are in place to provide emotional, mental health and social support for health care workers, especially those in family medicine.”

The consequences affect more than just physicians.

“It affects the person individually and the care that they provide, as well as the medical system itself,” Ofei-Dodoo said.

All that “noise” regarding emotional distress can cause doctors to be far from what led them to medicine in the first place: the desire to help others. And that, he said, can result in feeling less compassionate toward patients and to misdirect their frustration at colleagues and those they love.

“Instructors of the mindfulness-based reduction program led the study participants through techniques on how to deal with stress, focusing attention on the present moment in a non-judgmental way. Those mindfulness techniques actually helped the participants to deal with work-related stress,” Ofei-Dodoo said. “Participants of the study expressed that the mindfulness techniques provided a way for them to decompress and refocus their attention. It gave them a way to achieve their own self-care.”

Self-care is important at any time, but COVID-19 has made that even more so. Overwork and frustrations with patients who haven’t made good choices or listened to medical advice during the pandemic have exacerbated that.

Maurice Duggins, M.D., FAAFP, is one of the Ascension Via Christi family medicine faculty who took part in the mindfulness program. Duggins, a graduate of KU School of Medicine-Wichita and a clinical associate professor in the school’s Family & Community Medicine department, has been practicing for two decades. The program piqued his curiosity, as he had realized the pandemic was taking a toll on his compassion and interactions.

Two things he doesn’t like feeling, Duggins said, are negative emotions and “getting emotionally numb, because that makes me feel like I'm not caring. I'm a physician; I have to care. So even though what a patient is saying tells me I shouldn't care, I don't need to follow that path.”

“You may not even notice, because you're so focused on helping others, that your body's tense, that you're in pain, that your muscles are tight, and you need to relax. And mindfulness just gives you that idea of taking pause to feel what's going on with your body. Another thing that was taught was how to do breathing exercises, which helps with reducing tension and helping to enhance focus,” Duggins said, recalling recently shutting his office door and using those techniques.

As a teacher, the mindfulness training made him more aware of what residents might be feeling — or masking.

“When I ask someone how they are feeling, I know there’s more involved when I hear them say, ‘I'm OK, I'll be fine.’ I look for the opportunity where you can actually talk to them about mindfulness and whether they have other strategies they can use to help them deal with the stresses that they're going to inevitably encounter in the field of medicine.”

Learn more

Read the study by KU School of Medicine-Wichita researchers about emotional toll of the COVID-19 epidemic on Kansas family physicians.

Screenshot of program taught by Dr. Ofei-DodooAbove: Screenshot of mindfulness-based techniques program taught by Samuel Ofei-Dodoo, Ph.D., MPA, M.A., CPH, an assistant professor and director of residency research in the Department of Family & Community Medicine at KU School of Medicine-Wichita.

Top left: Profile photo of Samuel Ofei-Dodoo, Ph.D., MPA, M.A., CPH

KU School of Medicine-Wichita